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Figure 4a.   Biliary atresia in a 2-week-old boy with jaundice and hepatosplenomegaly. (a) Sagittal sonogram of the liver shows diffusely coarse echotexture, lack of visualization of the peripheral portal venous vasculature, and reduced beam penetration. There was hepatosplenomegaly, and the gallbladder measured only 8.2 mm in length. (b) Hepatobiliary scan obtained after a 35-minute delay demonstrates absence of activity in the central common bile duct and small intestine. Initial images (not shown) demonstrated poor uptake of the radionuclide by the liver.